Long-term functioning status of COVID-19 survivors: a prospective observational evaluation of a cohort of patients surviving hospitalisation

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Battistella, Linamara Rizzo ; Imamura, Marta ; De Pretto, Lucas Ramos ; Van Cauwenbergh, Simon K. H. A. A. ; Ramos, Vinicius Delgado ; Tome Uchiyama, Sabrina Saemy ; Matheus, Denise ; Kuhn, Flavia ; de Oliveira, Ana Alice Amaral ; Naves, Gabriella Souza ; Mirisola, Aline Rossetti ; Ribeiro, Fernando de Quadros ; Sugawara, Andre Tadeu ; Cantarino, Mauricio ; Santos Antunes Cavalca, Rafael Andrade ; Pagano, Vanessa ; Marques, Melina Valentim ; da Silva, Elizabeth Mendes ; Gomes, Alessandra Pereira ; Fregni, Felipe

• Document type: Journal article
• Source: BMJ OPEN; v. 12, n. 7, p. 11-pg., 2022-07-01.

Abstract

Objectives The study investigated the long-term functional status of hospitalised COVID-19 survivors to explore and document their functional situation. Design This prospective observational study assessed 801 COVID-19 survivors at 3-11 months after hospital discharge. It analyses participants' sociodemographic background, COVID-19 clinical manifestations, and clinical and functional evaluations. Setting Tertiary-level university hospital in Sao Paulo, Brazil. Participants Study participants are COVID-19 survivors admitted to hospital care for at least 24 hours to treat acute SARS-CoV-2 infection. Outcome measures Epworth Sleepiness Scale, EuroQoL-5 Dimensions-5 Levels, Functional Assessment of Chronic Illness Therapy-Fatigue, Functional Independence Measure, Functional Oral Intake Scale, Handgrip Strength, Insomnia Severity Index, Medical Research Council (MRC) Dyspnea Scale, MRC sum score, Modified Borg Dyspnea Scale, pain Visual Analogue Scale, Post-COVID-19 Functional Status, Timed Up and Go, WHO Disability Assessment Schedule 2.0, 1-Minute Sit to Stand Test. Results Many participants required invasive mechanical ventilation (41.57%, 333 of 801). Mean age was 55.35 +/- 14.58 years. With a mean of 6.56 (SD: 1.58; 95% CI: 6.45 to 6.67) months after hospital discharge, 70.86% (567 of 800) reported limited daily activities, which were severe in 5.62% (45 of 800). They also reported pain and discomfort (64.50%, 516 of 800), breathlessness (64.66%, 514 of 795), and anxiety and depression (57.27%, 457 of 798). Daytime sleepiness and insomnia evaluations showed subthreshold results. Most (92.85%, 727 of 783) participants reported unrestricted oral intake. Data indicated no generalised fatigue (mean score: 39.18, SD: 9.77; 95% CI: 38.50 to 39.86). Assessments showed poor handgrip strength (52.20%, 379 of 726) and abnormal Timed Up and Go results (mean 13.07 s, SD: 6.49). The invasive mechanical ventilation group seemed to have a better handgrip strength however. We found no clear trends of change in their functional status during months passed since hospital discharge. Conclusions Muscle weakness, pain, anxiety, depression, breathlessness, reduced mobility, insomnia and daytime sleepiness were the most prevalent long-term conditions identified among previously hospitalised COVID-19 survivors. (AU)

• FAPESP's process: 19/19465-0 - Development of novel speckle OCT analysis applied to the study of dynamic processes in microfluidic devices and animal models
• Grantee: Lucas Ramos de Pretto
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 20/08317-7 - Inhibitory deficit as a marker of neuroplasticity in rehabilitation
• Grantee: Simon Kristine Hans Andre Agnel Van Cauwenbergh
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)